Journal of critical care
-
Journal of critical care · Oct 2017
Development and implementation of an early mobility program for mechanically ventilated pediatric patients.
Early mobility (EM) is being used in adult ICUs in an effort to treat and prevent intensive care unit acquired weakness (ICU-AW) and Post-Intensive Care Syndrome (PICS). Data supports children suffer from ICU-AW and PICS as well. Our objective was to create and implement an EM protocol for pediatric patients receiving invasive mechanical ventilation. ⋯ Early mobility is attainable in a quaternary care PICU population without serious adverse events, using a multidisciplinary approach and appropriate staff education. Further research is needed to understand the physical and neurocognitive benefits of EM in children.
-
Journal of critical care · Oct 2017
Body weight-supported bedside treadmill training facilitates ambulation in ICU patients: An interventional proof of concept study.
Early mobilisation is advocated to improve recovery of intensive care unit (ICU) survivors. However, severe weakness in combination with tubes, lines and machinery are practical barriers for the implementation of ambulation with critically ill patients. The aim of this study was to explore the feasibility of Body Weight-Supported Treadmill Training (BWSTT) in critically ill patients in the ICU. ⋯ This proof of concept study demonstrated that BWSTT is safe, reduces staff resource, and facilitates the first time to ambulation in critically ill patients with severe muscle weakness in the ICU.
-
Journal of critical care · Oct 2017
Review Meta AnalysisIntubation using apnoeic oxygenation to prevent desaturation: A systematic review and meta-analysis.
To determine whether or not apnoeic oxygenation reduces the incidence of hypoxaemia during endotracheal intubation. ⋯ In patients whom are being intubated for any indication other than respiratory failure, apnoeic oxygenation at any flow rate 15L or greater is likely to reduce their incidence of desaturation (<90%) and critical desaturation (<80%). However, further high quality RCTs are required given the high degree of heterogeneity in many of the outcomes and subgroup analyses.
-
Journal of critical care · Oct 2017
Review Meta AnalysisRespiratory support techniques to avoid desaturation in critically ill patients requiring endotracheal intubation: A systematic review and meta-analysis.
To evaluate which respiratory support method for critically ill patients undergoing endotracheal intubation (ETI) is associated with less desaturation. ⋯ ApOx was significantly associated with higher minimum SpO2 registered during the intubation procedure. Further studies are needed to increase the number of included patients and demonstrate the benefit of ApOx and of other respiratory support methods (e.g. NIV, HFNC).
-
Journal of critical care · Oct 2017
ReviewInterventions affecting mortality in critically ill and perioperative patients: A systematic review of contemporary trials.
Confounders in randomized controlled trials (RCTs) reporting significant effects on mortality in critically ill patients using non-surgical techniques have not been systematically explored. We aimed to identify factors unrelated to the reported intervention that might have affected the findings and robustness of such trials. ⋯ These observations imply that major systematic biases exist and affect trial findings irrespective of the intervention being studied.